Patient Self Management Program: Living Well With COPD

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Happy elderly lady on tablet chatting with family members who live on the other side of the country

Aetonix and Respiplus are improving the lives of patients living with COPD through transformative care pathways delivered on the aTouchAway platform.

As the world’s most researched COPD self-management program, the LWWCOPD program facilitates patient improvements through supportive collaboration between patients living with COPD and healthcare providers.

The COPD Patient Self Management Program at a Glance 

The LWWCOPD program aims to promote the adoption of healthy lifestyle behaviors and the skills needed to better self-manage COPD on a day-to-day basis. With dynamic patient learning modules, virtual communication, remote patient monitoring, and more, this program along with the aTouchAway platform lets healthcare providers help patients living with COPD achieve the following:

  • Optimized quality of life
  • Maximized level of autonomy
  • Stabilized health condition
  • Prevention of disease progression

How This Program Works

Our program improves outcomes for patients living with COPD through virtual communication, education, remote monitoring, care plan management and clinical workflows. 

COPD Education – Onboarding

Patients will first complete a needs assessment and be evaluated on their condition with their current healthcare provider. This will ensure patients are ready to engage with all protocols in this program such as education, exacerbation follow up and so on.

COPD Education – Continuous Maintenance

Healthcare providers will collaborate with patients in setting up times to complete the learning modules of this program, as well as setting up the process for patients to continue education on their own. Once modules have been completed, patients continue to maintenance mode where they will learn about COPD self-management and develop an action plan for early exacerbation recognition and management.

COPD Respiratory Status Follow-up

Providers can easily monitor patients’ progress from their clinic to identify any early aggravation of symptoms to create an action plan, schedule appointments, and more. Through the aTouchAway platform, patients will be provided all the right tools to monitor their progress from the comfort of their own home.

COPD Self-Management Program Results

Our program produces life-changing results through effective COPD patient self-management.

Bourbeau et al. Arch Intern Med 2003.

Decreased Hospitalizations

After one year of enrolment in a self-managed COPD program, the probability of patients being hospitalized decreased by 40% compared to patients who had been receiving standard care.

Sustained Admission Reductions

In year one of being enrolled in a self-managed COPD program, patients were admitted to hospitals 42.6% less compared to those who received standard care, and in year two many patients continued to see improvements with a 26.9% reduction in admissions.

Gadoury et al. Eur Respir J 2005.

Bourbeau et al. Chest 2006.

Reduced Costs

On average, the total cost of healthcare resources needed per patient significantly decreased when patients with COPD utilized self-management programs over standard care.

Frequently Asked Questions

What is a Care Pathway?

A Care Pathway is a methodology that better enables patients to be connected to their care providers. It can include clinical protocols and workflows, virtual communications (voice and message), educational and coaching material for both the caregiver and the patient, assessment forms, surveys and questionnaires, and vital stats collection via remote patient monitoring.

What’s included in the Living Well with COPD Care Pathway?

With the COPD Care Pathway, patients can expect:

  • Guided education sessions covering COPD topics such as, managing symptoms and medication, being active and having a healthy lifestyle, breathing and airway clearance techniques, using and action plan and much more.
  • Additional ‘preparation’ and ‘post session’ educational resources to enhance patient integration and self-management
  • Daily monitoring of COPD symptoms to help identify exacerbations

Healthcare professionals can expect:

  • Simplified follow-up of people with COPD, adapted to their needs and level of severity
  • Automated assessment and evaluation forms for easy entry and reference
  • Agile process for patients, including notifications and reminders (eg. prompting to complete homework prior to the next education sessions)

Has the care pathway been patient validated?

The COPD Pathways integrated into the aTouchAway platform, are based on the successful results of the Living Well with COPD program (LWWCOPD). This self-management program was originally developed in 1998 and since then it has been tested in multiple clinical studies across the world, and it is supported by over 40 scientific publications. The LWWCOPD program has been adapted to 14 languages and it is used in a variety of clinical settings, attesting the program’s positive effects in improving patients lives while making a more effective use of healthcare resources. The LWWCOPD program is currently run by a non-profit society, RESPIPLUS™.

Can we make modifications to the care pathway for our specific hospital/care organization?

Select changes are available for patient onboarding and consent, as well as the identification of any other relevant and local resources that are useful for patients. For more information on how the COPD Care Pathway can be tailored to your organization’s needs, please contact us.

How would we go about deploying it to our patients?

Our teams at Aetonix and RESPIPLUS™ will make sure to provide your personnel the highest level of training to make sure that they develop the skills to support long-lasting behaviour change in the clientele affected by this chronic disease. Our trainers have extensive expertise in deployment with a focus on quality control and intervention fidelity (using the COPD Pathways as they are intended to).

Is this care pathway suitable for all patient types, such as seniors with zero technical skills?

Yes, zero technical skill is required and the patient interface can be modified and locked remotely to meet the technical ability of the user. The patient types include those affected by COPD. Your clinic may have a varied representation of patients, ranging from young (+40 yrs) and tech-savvy to seniors with co-morbid conditions and some cognitive impairment. The aTouchAway platform has been designed to accommodate all these user types.

When is the Care Pathway available for deployment?

Aetonix’s exciting partnership with the Live Life Well Program by RESPIPLUS™ is launching soon! The COPD Care Pathway will be available on February 9, 2021. We look forward to working with healthcare organizations around the world to deliver the best health outcomes for COPD patients.

I'd like to schedule a meeting to discuss our requirements

We would be happy to discuss how we can help your organization implement the COPD Care Pathway. To arrange a meeting, please click here.

What our customers say about us

Five star rating

Using the aTouchAway COPD Care Pathway, we have been able to support our patients at home with required respiratory and oxygen therapy, managing them safely and avoiding unnecessary hospital or clinic visits. aTouchAway proves to be effective in augmenting patient care while expanding team capacity and saving travel time for our organization.

Miriam Turnbull

VP & GM at ProResp

Case Study Square. Learn how Aetonix has helped other organizations. Click to read a case study.

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Group of health monitoring devices, like a digital scale, watches, blood pressure machine and a tablet and smartphone with the aTouchAway application opened
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COPD Education – Onboarding

Objective

To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

Timelines
One 60-90 min session with the Educator

Description
  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
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COPD Education – Continuous Maintenance

Objective 

To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

Description
  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
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COPD Respiratory Status Follow-up

Objective

Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

Description
  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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